medical billing answers


No Fault


No Fault insurance is medical coverage for injuries that are related to motor vehicles. No fault is always primary, no matter what other insurance coverage a person may have, in states where car insurance is mandatory.

No fault claims usually have to be reported within two weeks at a minimum. In some states, it's as soon as 48 hours. For medical facilities, there is usually an extra form that has to be completed to describe the details of the accident and the injuries of the patient. Because there are so many insurance carriers for no fault, sometimes the medical facility won't have these forms, and they'll have to be obtained from the insurance company.

Because of the nature of no fault claims, unlike compensation, if no fault coverage isn't verified within a week or so, medical facilities might change the insurance status of a patient to self pay, which means the patient is responsible for delivering whatever is needed in order for the medical facility to be able to bill the claim. One big reason for this is because often car accidents involve someone else who didn't have to report to the hospital, and their insurance might be liable for your claims. Hospitals do not get in the middle of what's known as third party claims, or claims where the injured party states that someone else is liable for payment, so the liability rests with the patient.

Most people don't know that any injury that occurs with a motor vehicle is considered a no fault claim. If you slam your finger in a car door, that's no fault. If you're injured in a car accident while on work time, that's considered a no fault claim. If a motorcycle hits you, it's a no fault claim, although many insurance companies won't cover motorcycles, and those that do won't cover motorcycles ridden out of season (some states have certain times of the year where motorcycles are supposed to be off the road).

If you ever have any questions as to whether or not your claim should be covered by no fault, contact your own car insurance carrier for more information.


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